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Female heart disease ‘less obvious’

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Women at risk of myocardial infarction may report different symptoms from men, a major international study has shown.

Stenoses of the arteries are also less likely to show up during angiogram, said the researchers in an online report published in the journal Heart.

They looked at data on 25,755 men and women in 14 countries who had experienced an acute coronary syndrome, such as MI or angina, over a seven-year period.

The symptoms reported by women when they first reached hospital were often different from men. While 94% of men and 92% of women reported chest pain, female patients were more likely than men to experience atypical symptoms such as nausea and jaw pain.

A striking finding was that women were twice as likely as men to have ‘normal’ or ‘mild’ results in an angiogram – with no single arterial blockage taking up more than half of any one blood vessel – despite other tests confirming they were having an MI or experiencing unstable angina.

‘We need to find out whether women might have blockages that are “invisible” on angiogram,’ said lead author Kim Eagle, professor of cardiovascular medicine at the University of Michigan.

‘We’ve made great strides in treating women with heart disease but this data shows there’s still much to be done,’ she added.

They found women were also significantly less likely than men to receive beta-blockers, statins and ACE inhibitors, or angioplasty and stenting – regardless of the seriousness of the arterial blockage.

Cathy Ross, cardiac nurse at the British Heart Foundation, said: ‘Symptoms of heart disease can be less obvious in women than in men, which may lead to a delay in diagnosis and appropriate treatment.

‘Sadly, heart disease kills more women every year than any other disease, so it’s vital they are diagnosed and cared for properly,’ she added.

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